Is Fibromyalgia a Cannabinoid Deficiency?

Fibromyalgia is a disease characterized by chronic, widespread pain. The cause is unknown, as the affected tissues do not appear to be diseased, and so there is no definitive test that can be performed to confirm a diagnosis. It is associated with poor quality of life, with additional symptoms of trouble sleeping, and fatigue. It is often found in patients who also suffer from anxiety and depression. Current treatments are largely ineffective, and patients are often required to take a variety of medications simultaneously to help alleviate symptoms. However, cannabis has been historically used to treat pain, and is known to be effective at treating neuropathic pain. Can cannabis treat fibromyalgia, as well?

While there are currently no large scale human clinical trials investigating the effect of cannabis on fibromyalgia, the results of smaller studies do give hope to fibromyalgia patients. The human studies performed thus far have used small numbers of patients and don’t always use adequate controls, so it is difficult to draw clinically relevant conclusions.

For example, one small study (each group had 28 participants) compared fibromyalgia patients that used cannabis as a treatment with those that did not. Cannabis users found that cannabis reduced not only pain associated with fibromyalgia, but also anxiety and sleep issues. There are also two studies using nabilone, a synthetic molecule that acts like THC, for the treatment of fibromyalgia. These studies found that nabilone reduced pain and increased quality of life and feelings of well-being as well as improving the sleep of fibromyalgia patients.

There is also an exciting idea that is gaining momentum and could lead to more clinically relevant studies in the future. The theory of Clinical Endocannabinoid Deficiency (CECD) hypothesizes that deficiencies in endocannabinoids may be at the root of a number of diseases that are resistant to mainstream therapies. The symptoms of these diseases align with the current understanding of the endocannabinoid system and its role in regulating various bodily systems. Fibromyalgia cannot be diagnosed by a tissue pathology (diseased neurons, for example) and is often accompanied by headaches, anxiety and depression. All of these symptoms are known areas of activity for the endocannabinoid system, and cannabinoids are known to improve these conditions in patients suffering from other maladies.

While there are no large scale clinical studies of cannabis for the treatment of fibromyalgia, a number of small studies do indicate that cannabis could help to modulate the pain, mitigate trouble sleeping, and reduce anxiety that characterizes the disease. Larger clinical studies are needed to make definitive and significant conclusions, but if the CECD theory continues to gain momentum, this could soon become a reality.